/ReclassificationResidencyApplication1

STATEMENT OF FLORIDA RESIDENCY FOR TUITION PURPOSES Reclassification To Florida Resident Note: To be eligible to reclassify to a Florida Resident you cannot have been enrolled full time in an institution of higher education for the prior 12 consecutive months before the start of the term you wish to take classes at Valencia.

An individual who is initially classified as a non-resident for tuition purposes (for example: you were previously enrolled in a Florida institution of higher education as a non-Florida Resident and paid non-Florida Resident tuition and fees) may become eligible for reclassification to a Florida Resident for Tuition Purposes only if that individual, or his or her parent if that individual is a dependent, supports permanent residency in Florida by presenting documentation of establishment of a bona fide domicile in this state for at least 12 consecutive months while not being enrolled full time in an institution of higher learning. The burden of proof is on the student and/or the claimant to show all of the following: Item 1: Certify that the claimant was not enrolled full time in a Florida institution of higher education as a non-Florida Resident;

Note: Students using a spouse as the claimant must provide copy of marriage certificate; spouse must complete the Statement and provide copies of their supporting documentation as outlined below. Student must also provide a copy of their Florida Driver’s License or Florida Identification Card (even if card was obtained less than 12 consecutive months ago).

Name of Student

Valencia ID or Social Security Number of Student

Item 2: Proof of residency in Florida for the requisite 12month period; and Item 3: Prove that residency in the state of Florida is/was not merely temporary or incidental to enrolling in a college or university located in Florida.

1 Dependency Dependent Student: If you are under age 24, you will be classified as a dependent student. A copy of your parent’s or legal guardian’s most recent federal income tax return may be required to establish dependency. In all cases, when the last names of the student and the claimant are different, proof of relationship is required.

Independent Student: If you meet any one of the following criteria, you will be classified as an independent student:

• You are 24 years of age or older prior to the Proof of Florida Residency deadline.

• You are married (copy of marriage certificate is required).

• You have a child who lives with you and receives his/her

support from you (copy of most recent federal income tax return listing the child as your dependent and/or copy of child’s birth certificate listing you as the parent is required).

• You have other dependents who live with you and receive their support from you (copy of most recent federal income tax return listing the person(s) as your dependent is required).

• You are a veteran of the United States Armed Forces or

serving on active duty (copies of military documents are required; example: DD 214; DD 2058).

• Your parents are deceased and you are, or were until age 18, a ward of the court (copies of court documents are required).

• You can provide documentation that you are not claimed

by your parent/legal guardian as a dependent under the federal income tax code and can document that you provide at least 50% of your own support for the cost of attendance as defined by the Valencia College Financial Aid Office (copy of your most recent tax return, W2, and/ or pay stubs are required as proof of income).

• You have been classified as independent for Financial

Aid purposes at Valencia (verification from Financial Aid Office is required).

© 2011 Valencia College/ADM080211-03

2 Documentation Required Documentation to Satisfy Items on Page One. To satisfy item number 1, the claimant and student certify with their signatures on this Statement of Florida Residency that the claimant did not attend an institution of higher education full time during the previous 12 consecutive months.

To satisfy item number 2 (proof of residence in Florida for 12 consecutive months), the student, or his or her parent/legal guardian if that student is a dependent, must have two (2) of the following three (3) documents that are dated at least 12 consecutive months prior to the Proof of Florida Residency Deadline; no exceptions to this requirement will be made: • Florida Driver’s License OR Florida Identification Card (required) • Florida Vehicle Registration • Florida Voter Registration *Florida ID card can be used only if there is no evidence of ties to another state (i.e. the claimant cannot possess a valid driver’s license from another state). o satisfy item number 3 (proof that claimant did not move T to Florida to attend a Florida institution of higher education), the student, or his or her parent/legal guardian if that student is a dependent, must provide proof of one of the following; no exceptions to this requirement will be made (copies of supporting documentation must be attached):

Lease agreement and proof of 12 consecutive months 7. ofpayments (lease must be current; copies of prior leases maybe used to establish 12 consecutive months). Copy of leaseagreement and letter from leasing agent/landlord as proof of payment is required (or other acceptable proof of payment such as copies of rent payment receipts).

8.

A Florida professional or occupational license (must be current and show at least 12 consecutive months; copy of license is required).

9.

The claimant has an immediate relative (i.e. parent or child) who is currently living in Florida and who has resided in this state for the previous 12 consecutive months (proof of relationship and proof of the immediate relative’s residency in Florida for the previous 12 consecutive months is required).

10. Proof of membership in a Florida-based charitable or professional organization (NOTE: membership in a church does not constitute membership in a Florida-based charitable organization). Membership must be current and must show membership in Florida for the previous 12 consecutive months (copy of membership card showing dates of membership or letter from charitable organization showing date membership began is required).

Declaration of Domicile (copy is required; must be certified by 1. a clerk of the court at least 12 consecutive months prior to the Proof of Florida Residency Deadline)

11.

The claimant is currently serving on U.S. military active duty in Florida (copy of military documents are required). The claimant has received a U.S. military discharge and established residency in Florida prior to initial enrollment (copy of DD 214 is required).

2.

Proof of purchase of a permanent home that is occupied as a primary residence of the claimant (copy of mortgage, deed, or Homestead Exemption are required; contracts/agreements must be dated 12 consecutive months prior to the Proof of Florida Residency Deadline).

12. The claimant lost his/her house or other domicile in another state due to a severe natural disaster or crisis resulting in a state of emergency (e.g. hurricane or earthquake) that occurred prior to initial enrollment. Copies of supporting documentation are required (example: insurance claims, FEMA documentation, etc.).

3.

Transcript from a Florida high school for multiple years or a Florida GED score report (only if high school diploma or GED was earned within the last 12 consecutive months); if high school transcript is used, claimant must be listed as the parent or legal guardian; GED may be used when claimant is the student. (Copy of High School transcript or GED score report is required)

Please print, sign, and mail this entire document with your other documents of proof. Or, you may submit all of your documentation in person on any campus Answer Center. Documentation may be mailed to:

4.

Proof of permanent full-time employment in Florida during the previous 12 consecutive months or proof of transfer to a full-time permanent job in Florida. Full-time employment is considered one or more permanent jobs for a minimum of 30 hours a week. Letter from employer stating date of hire, that the position is permanent (not seasonal), and that the claimant is full time and/or works 30 hours or more per week is required.

5.

Benefit histories from Florida agencies and/or public assistance programs for the previous 12 consecutive months (letter from agency/program or statement/summary of benefits showing 12 consecutive months is required).

6.

Utility bill and proof of 12 consecutive months of payment (cell/mobile phones cannot be used); service must be current and only one utility may be used. Letter from service provider or copies of service/billing statements covering the 12 consecutive month period is required.

Valencia College, P.O. Box 3028, Orlando, FL 32802-3028 Please be advised that residency will not be adjusted until all documents are received. Incomplete and/or illegible residency documentation will be returned to the student.

All documentation provided to prove Florida Residency must be current and must show 12 consecutive months in Florida.

Questions? Visit our Web site at www.valenciacollege.edu or call the Enrollment Services: 407-299-5000, ext. 1507.

3 StudeNT’S Information Are you a resident of the State of Florida?

Claimant’s Permanent Legal Address (A P.O. Box cannot be used)

For tuition purposes we need to know how long you’ve lived in Florida. To be considered a Florida Resident you must show proof of residency in the state for 12 consecutive months. The person claiming Florida residency is called the claimant. The claimant is the student if independent. If you are a dependent student then your parent or legal guardian is the claimant. In all cases, when the last names of the student and the claimant are different, proof of relationship is required. The claimant must complete the following steps and also sign this document.

Please type or print clearly using blue or black ink.

Name of Student

Street Address Apt. #

City State Zip

Citizenship of person claiming residency (claimant and student must present original Permanent Resident card, or other approved USCIS documentation of status, in person, to any campus Answer Center):

Student’s Social Security Number or Valencia ID Number

Yes, U.S. Citizen No.

Student’s Date of Birth

Name of Person claiming Florida Residency

Claimant’s Relationship to Student

If no, country of citizenship:

________________________________________________

Date claimant began establishing legal Florida residence and domicile:

Claimant’s Telephone Number

4 Documents of proof You must provide two forms of proof from the following list:

(Mark the box for documents you will be submitting)

(Each document must be current and at least 12 consecutive months old or older.)

Florida Driver’s License or Florida Identification card*.

Florida Vehicle Registration.

Florida Voter Registration.

List document used here.

Please type or print very clearly. Illegible information will result in Florida Residency documentation being returned to the student.

Your Florida Driver’s License or Florida Identification Card*: License Number Expiration Date

Date of Birth

Original Issue Date

Your Florida Vehicle Registration: Name(S) on Registration

Vehicle ID Number (VIn) or Title Number

Expiration Date

Original Issue Date

Your Florida Voter Registration: Number

County

You must provide one document that proves you did not move to Florida just to attend a Florida institution of higher education (see list numbered 1 through 12 above for acceptable documents) copy of document used is required and must be attached to this form.

Original Issue Date

5 Signature of certification This information is required.

I do hereby swear and affirm that the below named student is a U.S. Citizen/adjudicated Permanent Resident or other approved United States Citizenship & Immigration Services (USCIS) status that meets all requirements for classification as a Florida Resident for Tuition Purposes (if person claiming Florida Residency is a lawful Permanent Resident or in another approved USCIS category, original Permanent Resident Card or USCIS documentation is required; such documentation must be submitted in person to any Answer Center). My residence in Florida has been for the purpose of establishing a permanent home and is not primarily incidental to enrollment at a Florida institution of higher learning. I, the claimant hereby swear with my signature below, that I did not attend an institution of higher education full-time during the previous 12 consecutive months. I understand that if false or fraudulent statements are submitted in connection with documentation to establish residency, tuition and fees will be recalculated at the nonresidency rate and the student will be responsible for paying the additional monies due.

Print Name of Student

Student VID or Social Security Number

Signature of Person Claiming Florida Residency Date (Original Signature is Required)

Signature of Student Date (Original Signature is Required)

Mail Florida Residency documentation to:

Valencia College P.O. Box 3028 Orlando, FL 32802-3028